哮喘患儿呼出气冷凝液中半胱氨酰白三烯和8-异前列腺素的研究

Cysteinyl leukotriene and 8-isoprostane in exhaled breath condensate of asthmatic children

目的：通过比较哮喘患儿急性发作期、临床缓解期与健康儿童呼出气冷凝液（ exhaled breath condensate, EBC）中的半胱氨酰白三烯（cysteingl leukotrien, Cys-LTs）和8-异前列腺素（8-isoprostane,8-iso-PG）的水平,探讨这两种标记物对哮喘病情评估的作用。方法采用R-Tube收集受试儿童的EBC；运用双抗体夹心酶联免疫吸附试验,检测所有样本的Cys-LTs和8-iso-PG浓度；分析两种标志物在不同组间的差异,同时探讨两种标志物之间的相关性。结果（1） EBC中的Cys-LTs水平急性发作组较健康对照组高（ P〈0．05）；缓解组与其他两组差异无统计学意义（ P〉0．05）。（2） EBC中的8-iso-PG水平发作组较缓解组高（ P〈0．05）；缓解组较健康对照组高（ P〈0．05）。（3）对三组EBC中Cys-LTs和8-iso-PG分别进行相关性分析,发作组中Cys-LTs与8-iso-PG有显著相关性（ n1=35, r1=0．61, P〈0．05）,缓解组中两者无显著相关性。结论哮喘患儿EBC中8-iso-PG水平与哮喘严重程度有关,可作为疗效监测的客观指标。 Cys-LTs水平与哮喘恶化有关。两种标志物在哮喘发作时有相关性,提示此时气道氧化应激与炎症反应有一定关联。

Objective To analyze the change of cysteinyl leukotriene （ Cys-LTs） levels and 8-Isopros-tane （8-iso-PG） levels in the exhaled breath condensate （EBC） of asthmatic children from acute exacerbation to clinical remission, and investigate the role of the detection of Cys-LTs and 8-iso-PG in EBC in its severity and pathogenesis , and explore the relationship between the Cys-LTs and 8-iso-PG through measuring Cys-LTs levels and 8-iso-PG levels in the EBC of asthmatic children. Methods The outpatient or inpatient asthmatic children of the pediatrics and a group of healthy children were studied. All subjects′ EBC were collected by the R-Tube produced by American Respiratory Research. The concentration of Cys-LTs and 8-iso-PG in EBC were measured by enzyme-linked immunosorbent assay （ELISA）, and compared among children in asthmatic exacerbation, asthmatic remission, and healthy condition. The relevance of their change would be explored at the same time. Results （1） Cys-LTs levels in EBC were higher in asthma exacerbation, compared to healthy controls （P〈0. 05）, while no significant difference were found between asthmatic remission and asthmatic exacerbation or healthy controls （ P〉0. 05 ） . （ 2 ） 8-iso-PG levels was higher in asthmatic exacerbation compared to asth-matic remission （ P〈0. 05 ） . Moreover, the 8-iso-PG levels were significantly higher in asthmatic remission than in healthy controls （P〈0. 05）. （3） Through the relevance analysis of the Cys-LTs and 8-iso-PG levels in EBC among the three groups, Cys-LTs levels in EBC of asthmatic exacerbation significantly were correlated with 8-iso-PG levels （n1 =35, r1 =0. 61, P〈0. 05）, while there was no significant correlation between 8-iso-PG levels and Cys-LTs levels in asthmatic remission. Conclusion The increase of 8-iso-PG levels in EBC of bronchial asthmatic patients correlates with the disease and its control. Therefore, 8-iso-PG can be an objective indicator for asthmatic diagnosis and healing efficacy. Cy-LTs levels increase in the EBC of bronchial asthmatic according to disease severity. The two levels correlate during asthmatic exacerbation, indicating that a link be-tween airway oxidative stress and inflammation among asthmatics.